HomeMy WebLinkAbout20M03 CAMPAIGN TREASURER'S REPORT SUMMARY
(1) nn► L I f'-rte r cP C? LS-r AJ City ort?Rig71kANLY
Name _ Recc've t ffi o":t e City Olen<
(2) h 1 esti 2 ( (LI W '7 C ) r� 7 Date: �_
Time:
Address (number and street) By:
/ 1 t �, r Cl L L�f 5t Z l- 3 .3 0 J G
City, State, Zip Code
Li Check here if address has changed (3) ID Number:
(4) Check appropriate box(es)'
Li Candidate Office Sought: __ 0 ki1
❑ Political Committee (PC)
❑ Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From Q 3 / n ( / To 0; 3 / 3 ( / Report Type: �?C ,, 3
❑ Original ❑Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks Expenditures $ •
Loans $ Transfers to
Office Account $
Total Monetary $ •
Total Monetary $
In-Kind $ ,
(8) Other Distributions
$ -
(9) TOTAL Monetary Contributions To Dated (10) TOTAL Monetary Expenditures To Date
$ . / c $
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.93, F.S.)
1 certify that I have examined this report and it is true, correct, and complete:
(Type name) in L t- S l4 SUS%1 C-' (Type name) M L c.;75 ( Oki Y T O. ..)
❑ Individual(only for IE 0 Treasurer 0 Deputy Treasurer 0 Candidate 0 Chairperson(only for PC and PTY)
or electioneering comm.)
0/1 /.e.,,c_c, IT --
X
Signatur Signature /
Ds-DE 12(Rev.11113) SEE REVERSE FOR INSTRIXTICWS
CAMPAIGN TREASURER'S REPORT—ITEMIZED CONTRIBUTIONS
(1) Name L' 5 % o‘=.1. 7-0 (2) I.D. Number
(3)Cover Period / / a through raj 3 / 3 ( a (4) Page _ of
(6). (7) (8) f (9) (10) (ll) (12)
Pr WO Nems
() (Last,Stalk,First,Middle)
Sequence Street Address 1: Contributor Contribution fn-Yin
Number CALM**, Cods pyType Occupation Tie Description
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#7�
f ! �
13 11/13) f:. >